Palliative Care Team

[Celia M, ASN, RN]

I am researching into starting up a Palliative Care team for the 48 bedded rural hospital where I work. I have some info from CAPC but I was wondering if any of you had any insights, experiences or suggestions.

Thanks

Celia :)

[VivaLasViejas, ASN, RN]

I'm on a similar committee where I work, and one of the things you want to do at the outset is make sure all your committee members are on the same page as far as hospice is concerned. You want them to be familiar with the hospice philosophy and understand that palliative care is done differently from 'curative' or restorative care.......they will also need to have a good knowledge of the latest research in pain management, and be willing to train other staff members who will be caring for these patients later on.

[Katillac, RN]

I'm on a similar committee where I work, and one of the things you want to do at the outset is make sure all your committee members are on the same page as far as hospice is concerned. You want them to be familiar with the hospice philosophy and understand that palliative care is done differently from 'curative' or restorative care.......they will also need to have a good knowledge of the latest research in pain management, and be willing to train other staff members who will be caring for these patients later on.

I'm sorry, but I need to emphatically disagree with this. You are using hospice and palliative care interchangeably, and they are not the same. Patients receiving palliative care don't need to be hospice appropriate and can also be recieving curative treatment. Examples: A non-hospice patient getting chemo is having intractable nausea. Nothing the oncologist has tried is relieving the symptom. Palliative care specialists can consult and offer recommendations. Or, chronic CHFer is having dyspnea unrelieved by cardioactive meds, diuresing and respiratory support. Again, palliative medicine can consult even though the patient wants more than the "comfort measures" and still wants to be hospitalized and treated for acute episodes.

It may be helpful to think of palliative care as the umbrella specialty service for those with life threatening and/or chronic illness. Hospice is the subspecialty for people who are no longer seeking curative treatments and whose prognosis is six months or less because of their illness. In both cases, symptom management is the focus. In hospice it's referred to as "comfort care" but palliative care is designed to deliver a consulting service that also provides symptom relief. The biggest remaining difference in the two is that the hospice organization, under Medicare regulations, becomes the case manager, while this is not the case with palliative care.